Wait times for people seeking care at emergency departments across Ontario have dramatically increased over the past five years amid a “deepening Ontario hospital funding crisis,” according to a new report.
The study, published Monday by the left-leaning think tank Canadian Centre for Policy Alternatives, found that 90 per cent of patients waited 4.5 hours for an initial assessment by a physician at a hospital emergency room in Ontario in 2024/2025, up from 2.7 hours in 2020-21. This, the report states, represents an alarming 67 per cent increase over a five-year period.
“Emergency department wait times are a canary in the coal mine for health system performance,” Andrew Longhurst, the author of the study, said at a news conference on Monday morning.
“Emergency departments with long wait times and overcrowding signal that the overall health system is struggling to meet patient demand.”
Wait times for hospital admission from the emergency department also saw a significant increase, the report states.
In 2020-21, 90 per cent of patients in the emergency department who were waiting to be admitted into hospital waited an average of 29 hours. That jumped to 44 hours in 2024-25, an increase of 52 per cent, the report states.
These indicators, Longhurst said, demonstrate a system that is “under immense strain.”
Majority of hospitals are in the red
He noted that 55 per cent of hospitals in the province carried a deficit in 2024-25 and new data indicates that this number will increase to 70 per cent by the end of the 2025-26 fiscal year.
Longhurst said small hospitals are overrepresented in the group of hospitals running deficits. About 61 per cent of hospitals with operating revenues under $100 million ran a deficit last year despite representing only 49 per cent of all Ontario hospitals.
By contrast, of the hospitals with operating revenues above $100 million, only 49 per cent ran a deficit but represent 51 per cent of all Ontario hospitals.
“Smaller and rural hospitals are among the hardest hit by provincial funding austerity,” Longhurst said.
“Smaller hospitals generally have fewer resources to draw upon than large urban hospital systems… The report raises concerns about the ongoing financial sustainability of smaller hospitals if provincial funding fails to cover increasing operating costs.”
By region, northern and western parts of the province were more likely to see hospitals with deficits.
In the Local Health Integration Networks (LHIN) regions of Erie St. Clair and Mississauga Halton, all hospitals were in deficit last year.
“Provincial funding austerity is shrinking the public hospital capacity required to ensure patients receive timely access to care,” Longhurst said.
He added that the Financial Accountability Office of Ontario (FAO) has previously estimated that $6.4 billion in new health care spending is in needed in 2026-27 “just to maintain 2024-25 service levels.”
Despite this, the province has only earmarked $3.4 billion in additional spending, leaving a $3 billion shortfall in that fiscal year.
“Costs in the hospital sector have been increasing by about six per cent each year due to population health, aging, and inflation, according to the Ontario Hospital Association,” Longhurst said.
“The provincial government’s projected to increase funding by only four per cent.”
In response to the report, a spokesperson for Ontario Health Minister Sylvia Jones called the claims “misguided.”
Jones also addressed the report during an earlier media availability in which she said that the province is focused on helping hospitals that are “experiencing very high deficit rates,” particularly those in remote and rural areas.
“As you know, this will be the fourth year in a row where we have supplied, invested $1.1 billion in hospital annualized operating budgets, which equates to about four per cent,” she told reporters at an unrelated news conference on Monday.
She said the province is trying to make sure that “money that is going into the system is actually going into that patient-focused care.”
“That is the work we are doing with hospital CEOs to make sure that they are using best practices, that innovation that is happening in so many other Ontario hospitals can be scoped and scaled to other hospitals,” she said.
Longhurst said the evidence doesn’t point to inefficiencies as much as to “just not enough funding all around.”
He added that Ontario trails all other provinces in total health care spending per capita, according to information from the Canadian Institute for Health Information.
“I ask the minister what evidence she has to come to that conclusion,” he said Monday.
“The government would need to be more clear about what they mean in that regard.”
‘An intensification of the cuts’
The report calls for the provincial government to implement “an aggressive plan to address the hospital funding and capacity crisis” as well as develop a “health care workforce strategy and capital plan.”
Michael Hurley, the president of the Ontario Council of Hospital Unions, says he hopes the province will reconsider their position on funding.
“What we are looking at down the road here is an intensification of the cuts. We are looking at ongoing access problems and a degradation in the quality of care,” he told reporters on Monday.
“We are really hope the government takes another look at this problem and changes its attitude.”
